一项针对 80 岁及以上自理老年患者新发跌倒和脆性骨折风险因素的前瞻性队列研究。
A prospective cohort study of the risk factors for new falls and fragility fractures in self-caring elderly patients aged 80 years and over.
机构信息
Department of Geriatrics, Beijing Tongren Hospital, Capital Medical University, Beijing100730, China. No.1 of Dong Jiao Min Xiang, Dongcheng District, Beijing, 100730, China.
Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing Institute of Otolaryngology, Key Laboratory of Otolaryngology Head and Neck Surgery(Capital Medical University) , Ministry of Education, Beijing100730, China. No.1 of Dong Jiao Min Xiang, Dongcheng District, Beijing, 100730, China.
出版信息
BMC Geriatr. 2021 Feb 10;21(1):116. doi: 10.1186/s12877-021-02043-x.
BACKGROUND
This study aimed to prospectively analyze the risk factors for new falls and fragility fractures in self-caring elderly patients and to find suitable evaluation tools for community screening and follow-up interventions.
METHODS
A total of 300 participants (187 male and 113 female), aged 80 or above and capable of caring for themselves, were enrolled in this study and observed for a period of 12 months. Their medical histories were collected, various indicators were measured, and the risk factors for new falls and fragility fractures were analyzed.
RESULTS
A total of 290 participants were included in the statistical analysis. Eighty-seven participants (30%) had new falls. The incidence was negatively correlated with the activities of daily living (ADL, represented by the Barthel Index) score (P=0.008) but was positively correlated with the timed up-and-go (TUG) test score> 12 s (P=0.021). The results also revealed that 33 fragility fractures occurred in 29 patients (10.0%), which was positively correlated with new falls (P=0.000). New fragility fractures were negatively correlated with the bone mineral density (BMD) of the lumbar vertebrae (P=0.012) and walking speed (P=0.000).
CONCLUSION
TUG, walking speed, the ADL score, and the fall risk assessment scale can simply and effectively assess the risk of new falls and fragility fractures in the elderly population, and their use should be widely implemented in the community.
背景
本研究旨在前瞻性分析自理老年人新发跌倒和脆性骨折的危险因素，并寻找适合社区筛查和随访干预的评估工具。
方法
共纳入 300 名年龄在 80 岁及以上、能够自理的参与者，观察期为 12 个月。收集他们的病史，测量各项指标，并分析新发跌倒和脆性骨折的危险因素。
结果
共纳入 290 名符合条件的参与者进行统计分析。87 名（30%）参与者发生了新发跌倒。发生率与日常生活活动（ADL，以巴氏指数表示）评分呈负相关（P=0.008），但与 12 秒以上计时起立行走测试（TUG）评分呈正相关（P=0.021）。结果还显示，29 名患者发生了 33 例脆性骨折（10.0%），与新发跌倒呈正相关（P=0.000）。新发脆性骨折与腰椎骨密度（BMD）（P=0.012）和行走速度（P=0.000）呈负相关。
结论
TUG、行走速度、ADL 评分和跌倒风险评估量表可简单有效地评估老年人新发跌倒和脆性骨折的风险，应在社区广泛应用。
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